Community Health & Wellness Services Request

Thank you for your interest in partnering with Henry Ford Health System for your community event. Currently, our community health and wellness support services are offered at no-cost to non-profit organizations serving the community at free events.

The Henry Ford Center for Health Promotion and Disease Prevention is available for all other requests. Please visit their website for more information.

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Today's Date
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Do you have a 501 (c)3 on file? These services are for “non-profit” organizations, other entities interested can visit henryford.com/worksitewellness for information

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Organization Type (select one)









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What services are you requesting from Henry Ford Health System?



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Do attendees have to pay a registration/entrance fee?


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Date of Event
(mm/dd/yyyy)
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Number of people expected





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Who will attend this event














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Audience gender


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Additional Information (check all that apply)





Is the event targeted toward a specific racial or ethnic group?


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Will you have extension cords available for our staff?


Will the event be indoors or outdoors?


If your event is outdoors, are there plans for weather contingencies?


Do you consent to allow HFHS to list this event on our publicly-accessed community calendar?


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Please fill out the following information if you are requesting presentation services
What equipment will be available to the speaker?




Schedule Appointment Online

** Check with your insurance carrier for coverage limitations.

If you can't find a date/time that works for you please call the provider’s office. Not all appointment types at all locations are available online.

Henry Ford Health System is committed to ensuring our Deaf or hard-of-hearing patients and visitors have equal access to all services. We provide the appropriate auxiliary aids and services, including qualified sign language interpreters, TTYs and other assistive listening devices, at no cost. To request assistance, call 313-916-1896 or email CommunicationAccess@hfhs.org.

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